Prophylactic intravenous carbetocin versus oxytocin during caesarean section under spinal anaesthesia in high risk parturients: A comparative study

Abstract

Objective: To compare the effects of carbetocin and regular oxytocin on blood loss during Caesarean section under spinal anaesthesia.
Design: Randomized prospective comparative study.
Setting: University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria.
Participants: Eighty parturients undergoing Caesarean delivery under spinal anaesthesia.
Main outcome measure: The primary outcome was defined as the volume of intraoperative blood loss. Secondary outcomes were incidence of hypotension, need for blood transfusion, number needed for more treatment with blood, and neonatal outcome.
Results: Parturients in both groups were demographically comparable. Haemodynamic changes were similar, however there was a statistically significant difference in the mean change in heart rate; carbetocin group was 14.5±5.2 beats per minute versus 23.4±7.8 beats per minute in the oxytocin group (p=0.04). . The mean EBL for the oxytocin group was 700±50.55 ml while 280±40 ml for the carbetocin group; p=0.03. The APGAR scores and umbilical pH were comparable in the two groups.
Conclusion: It was observed that carbetocin significantly reduced blood loss with minimal side effects than oxytocin in the women studied. The routine use of carbetocin could be the way forward in preventing obstetric haemorrhage in the vulnerable parturient.